Treatment

Primary attention should be given to the re-establishment of adequate respiratory
exchange through provision of a patentairway and the institution of assisted
or controlled ventilation. Naloxone, a narcoticantagonist, can reverse respiratory
depression and coma associated with opioid overdose or unusual sensitivity to
opioids, including hydrocodone. Therefore, an appropriate dose of naloxone hydrochloride
should be administered intravenously with simultaneous efforts at respiratory
resuscitation. Since the duration of action of hydrocodone may exceed that of
the naloxone, the patient should be kept under continuous surveillance and repeated
doses of the antagonist should be administered as needed to maintain adequate
respiration. Supportive measures should be employed as indicated. Gastric emptying
may be useful in removing unabsorbed drug. In cases where consciousness is impaired
it may be inadvisable to perform gastric lavage. If gastric lavage is performed,
little drug will likely be recovered if more than an hour has elapsed since
ingestion. Ibuprofen is acidic and is excreted in the urine; therefore, it may
be beneficial to administer alkali and induce diuresis. In addition to supportive
measures the use of oral activated charcoal may help to reduce the absorption
and reabsorption of ibuprofen. Dialysis is not likely to be effective for removal
of ibuprofen because it is very highly bound to plasma proteins.

CONTRAINDICATIONS

VICOPROFEN (hydrocodone and ibuprofen) is contraindicated in patients with known hypersensitivity to hydrocodone
or ibuprofen. Patients known to be hypersensitive to other opioids may exhibit
cross-sensitivity to hydrocodone.

VICOPROFEN (hydrocodone and ibuprofen) should not be given to patients who have experienced asthma, urticaria,
or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely
fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients
(see WARNINGS - Anaphylactoid Reactions,
and PRECAUTIONS - Preexisting Asthma).